The Development of an Internet Course as an Integral Component of Face-to-Face Treatment of Major Depressive Disorder (MDD)

Abstract

The study tested the feasibility of a self-learning interactive online course on Cognitive Behaviour Therapy (CBT) as a component in an intervention for the treatment of participants with mild or moderate levels of major depressive disorder (MOD). The course provided a means for participants to learn cognitive behavioural skills through an interactive website with email and if necessary telephone support by the writer. The intervention included individual face-to-face sessions, which participants arranged as they felt the need during or after completion of the course. The sessions concentrated on the application of skills learnt in the course and overcoming difficulties encountered in learning aspects of the course. Nine participants scoring in the mild and moderate levels on the Beck Depression Inventory (BDI) were selected for the study. The existence of MOD was verified by a clinical interview based on the Hamilton Depression Rating Scale (HDRS). Participants were retested with the BDR on completion of the intervention, the face-to-face phase and three months following the end of treatment. The BDI scores were compared with those of individuals in studies of face-to-face treatment and online treatment only, to identify significant differences in effect sizes or improvement rates. At the same time as the BOI testing participants completed interview questionnaires on the extent to which they were using skills learnt in the intervention and also provided feedback on the treatment process. Case study methodology was used to provide information on changes in functioning as participants advanced through the treatment process. The results are tentative because the study has several limitations including the smallness of the sample, the lack of control groups and the nature of the relationship between the researcher and the participants. Much more research is required before the effectiveness of the intervention can be accepted.